Bottom Line:
Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups.These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders.Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients.

ABSTRACTDue to its unique pharmacodynamic properties of dopamine partial agonist activity, and its association with few and mild side effects, aripiprazole is a candidate atypical antipsychotic for patients with tic disorders. This open-label study compared the efficacy and tolerability of aripiprazole with haloperidol, a typical antipsychotic widely used to treat patients with tic disorders. Forty-eight children and adolescents with tic disorders were recruited from the outpatient clinic at South Korea and treated with aripiprazole (initial dose, 5.0 mg/d; maximum dose 20 mg/d) or haloperidol (initial dose, 0.75 mg/d; maximum dose, 4.5 mg/d) for 8 weeks. Treatment efficacy was measured using the yale global tic severity scale (YGTSS), and tolerability was measured using the extrapyramidal symptom rating scale (ESRS) and an adverse effects checklist. Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups. ESRS scores were significantly higher in the haloperidol group during the 4 weeks after commencement of medication (p < 0.05). These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders. Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients.

Fig2: Changes in ESRS scores over time in the aripiprazole and haloperidol treatment groups. AbbreviationsESRS extrapyramidal symptom rating scale. The error bars refer to standard deviation

Mentions:
The total ESRS score at study endpoint was higher in the haloperidol than in the aripiprazole group. There were interaction effects between groups and a time effect of the total ESRS score (Z = −2.17, p = 0.03). Total ESRS scores did not change significantly in the aripiprazole group between 2 and 4 weeks (1.1 ± 1.7 and 1.1 ± 1.8, respectively), but increased significantly in the haloperidol group between 2 and 4 weeks (1.4 ± 2.1 and 2.8 ± 2.6, respectively); these interaction effects were statistically significant (Z = −2.083, p = 0.037) (Fig. 2). In addition, the subscale scores for Parkinsonism, akathisia and, dystonia were higher in the haloperidol group at 8 weeks. The Parkinsonism subscale of the ESRS showed an interaction effect between group and time Z = −2.06, p = 0.04). No subjects experienced dyskinesia in this study (Table 3).Fig. 2

Fig2: Changes in ESRS scores over time in the aripiprazole and haloperidol treatment groups. AbbreviationsESRS extrapyramidal symptom rating scale. The error bars refer to standard deviation

Mentions:
The total ESRS score at study endpoint was higher in the haloperidol than in the aripiprazole group. There were interaction effects between groups and a time effect of the total ESRS score (Z = −2.17, p = 0.03). Total ESRS scores did not change significantly in the aripiprazole group between 2 and 4 weeks (1.1 ± 1.7 and 1.1 ± 1.8, respectively), but increased significantly in the haloperidol group between 2 and 4 weeks (1.4 ± 2.1 and 2.8 ± 2.6, respectively); these interaction effects were statistically significant (Z = −2.083, p = 0.037) (Fig. 2). In addition, the subscale scores for Parkinsonism, akathisia and, dystonia were higher in the haloperidol group at 8 weeks. The Parkinsonism subscale of the ESRS showed an interaction effect between group and time Z = −2.06, p = 0.04). No subjects experienced dyskinesia in this study (Table 3).Fig. 2

Bottom Line:
Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups.These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders.Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients.

ABSTRACTDue to its unique pharmacodynamic properties of dopamine partial agonist activity, and its association with few and mild side effects, aripiprazole is a candidate atypical antipsychotic for patients with tic disorders. This open-label study compared the efficacy and tolerability of aripiprazole with haloperidol, a typical antipsychotic widely used to treat patients with tic disorders. Forty-eight children and adolescents with tic disorders were recruited from the outpatient clinic at South Korea and treated with aripiprazole (initial dose, 5.0 mg/d; maximum dose 20 mg/d) or haloperidol (initial dose, 0.75 mg/d; maximum dose, 4.5 mg/d) for 8 weeks. Treatment efficacy was measured using the yale global tic severity scale (YGTSS), and tolerability was measured using the extrapyramidal symptom rating scale (ESRS) and an adverse effects checklist. Total tic scores as measured by the YGTSS decreased over time in both groups (p < 0.001) without any significant differences between groups. ESRS scores were significantly higher in the haloperidol group during the 4 weeks after commencement of medication (p < 0.05). These results indicate that aripiprazole may be a promising drug in the treatment of children and adolescents with tic disorders. Further controlled studies are needed to determine the efficacy and tolerability of aripiprazole in these patients.